Citation NR: 9614218
Decision Date: 05/23/96 Archive Date: 06/04/96
DOCKET NO. 92-15 601 ) DATE
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On appeal from the
Department of Veterans Affairs (VA) Regional Office (RO) in
Phoenix, Arizona
THE ISSUE
Entitlement to service connection for bipolar disorder.
REPRESENTATION
Appellant represented by: Disabled American Veterans
WITNESS AT HEARING ON APPEAL
Appellant
ATTORNEY FOR THE BOARD
G. Wm. Thompson, Counsel
INTRODUCTION
The veteran had active military service from June 1969 to
December 1971.
This case was previously before the Board of Veterans'
Appeals (Board) and remanded for further development in
November 1993. As a result of the remand, by rating action
in February 1995, a 100 percent evaluation was assigned for
post-traumatic stress disorder (PTSD) with abuse of alcohol
and drugs. The assignment of a total rating for the PTSD
rendered the total rating issue moot. The only issue now on
appeal is service connection for a bipolar disorder.
The Board notes that the veteran, in a letter received in
March 1995, asked how he could get his 2 Bronze Star medals.
The VA in not responsible for issuing decorations earned in
service, and the veteran should contact the Department of the
Army in this regard.
REMAND
The recorded psychiatric history for the veteran, in file,
starts in January 1973, with a diagnosis of paranoid
schizophrenia. Between 1973 and 1986 there were a variety of
diagnoses for the veteran, to include borderline personality
disorder, substance abuse, adjustment disorder with
depression, atypical personality disorder, explosive
personality disorder, and PTSD. Alcohol and drug abuse were
noted, with drug abuse in service and continuing thereafter.
Information recorded for clinical purposes, on private
psychiatric examination in 1983, was to the effect the
veteran exhibited disruptive behavior in school, at age 7,
and saw a psychiatrist then. He quit school after the 8th
grade, at age 16. By rating action in March 1983, service
connection was established for PTSD with abuse of alcohol and
drugs. Diagnoses of bipolar disorder for the veteran started
in about 1988.
The veteran's representative, in a written presentation dated
in May 1996, reported that the veteran argued that a grant of
service connection for bipolar disorder could not be
disassociated from the service-connected PTSD in light of
Allen v. Brown,
7 Vet.App. 439 (1995). Such an issue is inextricably
intertwined with the issue on appeal. In view of this case,
the Board must find that the record remains inadequate to
resolve the issue on appeal since the RO has not yet had an
opportunity to address this argument. Accordingly, this case
is remanded for action as follows:
1. In hearing testimony in January 1992,
Transcript, page 8, the veteran reported
ongoing psychiatric treatment to include
seeing a social worker and psychologist.
The veteran should be offered an
opportunity to provide additional
information concerning treatment for a
bipolar disorder. Medical evidence or
opinion of a relationship between the
disability at issue and any incidents of
the veteran's service or a service-
connected disability would be helpful.
The RO should associate with the claims
folder all psychiatric treatment records
since June 1991.
2. The RO should arrange for the veteran
to undergo complete psychological testing
by the VA. A complete personality
profile should be included.
3. Following completion of the
foregoing, arrangements should be made
for the veteran to undergo a special
psychiatric examination by a panel of VA
psychiatrists. The claims folder must be
made available to the examiners, and
reviewed in conjunction with the
examination. The examining physicians
are requested to specifically address the
following questions:
(a) What is the degree of medical
probability that any current bipolar
disorder is causally related to service
or to a service connected disability?
(b) If the examiners believe that the
appellant has a bipolar disorder that was
not proximately caused by service or a
service connected disability, they should
provide an opinion as to whether a
bipolar disorder is aggravated by a
service connected disability; if
applicable, the examiners are
respectfully requested to identify the
quantum of additional disability due to
the aggravation caused by the service
connected disability, over and above the
level of disability due to the underlying
disorder. If the examiners cannot
quantify the degree of increased
disability, the examiners are requested
to explain how it may be ascertained that
such additional disability exists without
resort to speculation.
Thereafter, the case should be reviewed by the RO, including
with consideration of Allen v. Brown, 7 Vet.App. 439 (1995).
If any benefit sought remains denied, the veteran and his
representative should be provided with a supplemental
statement of the case and be given opportunity to respond.
The case should then be returned to the Board for further
appellate consideration.
M. SABULSKY
Member, Board of Veterans' Appeals
The Board of Veterans' Appeals Administrative Procedures
Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, 741
(1994), permits a proceeding instituted before the Board to
be assigned to an individual member of the Board for a
determination. This proceeding has been assigned to an
individual member of the Board.
Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the
Board of Veterans' Appeals is appealable to the United States
Court of Veterans Appeals. This remand is in the nature of a
preliminary order and does not constitute a decision of the
Board on the merits of your appeal. 38 C.F.R. § 20.1100(b)
(1995).
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